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The Greatest Threat to America

Contrary to what we are being told by our current political leadership, the greatest threat to America is not terrorism, immigration or our trade deficit with China. It is the fact that nearly sixty percent of our children are exposed, at a very early age, to one or more risk factors that can severely and profoundly compromise their ability to succeed. We cannot solve this problem by investing more money in prisons, but only by investing in our communities. And our children cannot be shielded from these risk factors by building a wall; but only by building strong, successful families.

The most effective way to improve the health of our population and our society is to invest in preventing the adverse childhood experiences that are directly linked to behavioral and learning problems, school failure, the adult onset of chronic disease, mental illness, subsequent involvement in the social support system and often in the criminal justice system. Turning that around— ensuring that these children have an equal opportunity to succeed—is perhaps the most important domestic challenge we face today and requires addressing their families and the communities in which they live.

The fact is, that if we were to make a strategic investment in these children and their families—starting before birth—and could sustain that investment even for ten years— we would fundamentally change the face of America. We could address the opportunity gap that bakes in a high likelihood of failure for children from generational poverty, children of color, and English language learners before they even reach the first grade. We could produce a generation of children who reach school ready to learn and who would have an equal opportunity for success. And we would save literally billions of dollars downstream in a more productive workforce, more engaged citizens and through the avoided expenditures in health care, social supports and the criminal justice system.

We know who these at-risk children and families are. We can identify them right down to zip code, neighborhood and often household. And we have well-researched and effective interventions, treatments and supports that could profoundly and positively change the life arc of these children. Yet one of the greatest frustrations and contradictions in American public policy is that we have not done so.

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As an emergency physician John Kitzhaber saw medical problems that started first as social problems in the home. This led to his lifelong commitment to at risk children and families, reflected in his work during three terms as governor: the Oregon Children’s Plan; the transformation of Oregon’s early childhood delivery system; and the creation of the Early Learning Council and local Early Learning Hubs.